| NPI | 1497700025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: TX 0238) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: NY 14062) |
| 1041C0700X Social Worker, Clinical (Licence: TX 61378) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-05-06 |